Clinical Profile of Adult Patients with Hyperglycemic Crisis at the De La Salle University Medical Center, A Ten-Year Retrospective Study

Publication Date

1-1-2022

Document Type

Article

Publication Title

Phillippine Journal of Internal Medicine

Abstract

This current study aims to report the clinical profiles and characteristics of diabetic patients who had been admitted for hyperglycemic crises from 2007 to 2017 at our institution. Methodology. We conducted a retrospective study in a tertiary care university hospital outside Metro Manila. The data gathered were divided into three categories: clinical data, biochemical data and precipitating factors. Results. A total of 3,120 adult patients with diabetes mellitus were admitted for various reasons, and 71 cases presented with DKA or HHS over the 10-year period of review which is equivalent to 2% of all diabetes mellitus cases admitted. Forty-six (64.79%) of the patients with hyperglycemic crises were known diabetics with a duration of 7-13 years. Majority of patients were not taking anti diabetic medications upon admission. Most patients with hyperglycemic crises were tachycardic and hypertensive upon admission. Majority were discharged and improved. Majority of the cases 53 (81.69%) had DKA. The most common precipitating factor in DKA and HHS was infection. Conclusion. In conclusion, the biochemical profiles in our series did not significantly differ from the past study by Gatbonton et.al (1998). Despite the advent of new therapies for diabetes mellitus control, mortality among the patients with hyperglycemic crises was slightly higher in our study at 11% compared to the global reported data of 2-10%. One of the reasons could be the minimal improvements in our health care delivery system that is still unable to cater to the needs of diabetic Filipinos. Early screening programs should be done for patients beginning age 40 years and even earlier for those with risk factors for prompt detection and treatment of diabetes mellitus. Education and awareness should be strengthened for patients with diabetes mellitus to avoid the crises by emphasizing the importance of regular follow-up, monitoring and compliance with a diabetic regimen, especially with insulin and multiple OADs (oral anti-diabetic drugs) since the disease is progressive, and timely intensification of therapy is needed.

First Page

162

Last Page

168

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